Human Milk Practices in Swedish Neonatal Units: Results From a Nationwide Survey

The aim of this study was to describe the routines for handling mother's own milk and donor human milk in Swedish neonatal care units related to national guidelines.

A web-based survey of 24 of 38 neonatal units and 19 of 28 human milk banks in Sweden.

Despite national guidelines, breast milk handling varied widely. All units offered lactation support and free breast pumps during hospital stays; nine continued post-discharge. Use of mother's milk differed; some prioritised fresh, others mixed or used frozen milk by age. Donor milk was mainly given to infants < 34-35 weeks or post-surgery, though criteria varied. Some also provided it for hypoglycaemia, growth restriction or hypothermia treatment. Fortification routines varied in both target groups and preparation, ranging from bedside at each feed to once daily. Most milk banks tested donor milk before pasteurisation; one tested both before and after. Five units never declined donations, while others did due to storage limits, surplus supply or time constraints.

Substantial variation in practices indicates a need to clarify and update national guidelines and strengthen milk banking, with relevance both nationally and internationally.